Provider Demographics
NPI:1174958854
Name:RODRIGUEZ DENTAL OFFICE, P.C.
Entity type:Organization
Organization Name:RODRIGUEZ DENTAL OFFICE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-RAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:202-659-8568
Mailing Address - Street 1:919 18TH ST NW
Mailing Address - Street 2:SUITE LL-52
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-5503
Mailing Address - Country:US
Mailing Address - Phone:202-659-8568
Mailing Address - Fax:202-659-1016
Practice Address - Street 1:919 18TH ST NW
Practice Address - Street 2:SUITE LL-52
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-5503
Practice Address - Country:US
Practice Address - Phone:202-659-8568
Practice Address - Fax:202-659-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1000393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty